Healthcare Provider Details

I. General information

NPI: 1023947132
Provider Name (Legal Business Name): TAYLOR MULLEN M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 ROSENEATH RD UNIT 158
RICHMOND VA
23230-4631
US

IV. Provider business mailing address

1310 ROSENEATH RD UNIT 158
RICHMOND VA
23230-4631
US

V. Phone/Fax

Practice location:
  • Phone: 804-476-8968
  • Fax:
Mailing address:
  • Phone: 804-476-8968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704019121
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: